H. pylori plays a role in the pathogenesis of gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT).
Eradication therapy is a widely accepted initial treatment of stage I disease.
In this study, physicians from Austria and Germany determined the long-term outcome of patients undergoing exclusive H. pylori eradication therapy.
|Complete regression of lymphoma occurred in 62% of patients.|
The team evaluated a prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT.
They followed 90 patients for at least 12 months.
The physicians performed a complete staging work up revealing stage I disease and H. pylori infection.
The patients received either omeprazole 20 mg, metronidazole 400 mg, and clarithromycin 250 mg twice daily, or omeprazole 20 mg, amoxycillin 1000 mg, and clarithromycin 500 twice daily, for 1 week.
Median follow up was 44.6 months.
The team found that H. pylori was successfully eradicated in 98% of patients.
They also found that complete regression of lymphoma occurred in 62% of patients, minimal residual disease remained in 18%, and partial remission occurred in 12%.
There was no change in 4% patients, and progressive disease in 2% patients.
The team determined that 4 patients with complete remission relapsed after 6, 8, 8, and 15 months. One of these patients was reinfected with H. pylori.
In addition, they established that the regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound.
Dr Fischbach's team concluded, "The majority of patients with low grade gastric MALT lymphoma treated by exclusive H. pylori eradication have a favorable long term outcome, offering a real chance of cure".